Department of Orthopedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing, 100191, China.
BMC Musculoskelet Disord. 2023 Apr 12;24(1):281. doi: 10.1186/s12891-023-06347-4.
Spinal giant cell tumor (SGCT) is a relatively rare primary tumor. En bloc resection is the preferred surgical procedure for it due to its aggressiveness, meanwhile leading to more complications. We reported the characteristics of perioperative complications and local control of total tumor resection including en bloc resection and piecemeal resection for primary thoracic and lumbar spinal giant cell tumors in a single center over 10 years.
This is a retrospective cross-sectional and cohort study. Forty-one consecutive patients with SGCTs who underwent total tumor resection from 2010 to 2020 at our institution and were followed up for at least 24 months were reviewed. Surgery data, complication characteristics and local tumor control were collected and compared by different surgical procedure.
Forty-one patients were included, consisting of 18 males and 23 females, with a mean age of 34.2 years. Thirty-one had thoracic vertebra lesions, and 10 had lumbar vertebra lesions. Thirty-five patients were primary cases, and 6 patients were recurrent cases. Eighteen patients were treated by total en bloc spondylectomy (TES), 12 patients underwent en bloc resection according to WBB surgical system, and 11 patients underwent piecemeal resection. The average surgical time was 498 min, and the mean estimated blood loss was 2145 ml. A total of 58 complications were recorded, and 30 patients (73.2%) had at least one perioperative complication. All patients were followed up after surgery for at least 2 years. A total of 6 cases had postoperative internal fixation failure, and 4 cases presented local tumor recurrence (9.8%).
Although the surgical technique is difficult and accompanied by a high rate of perioperative complications, en bloc resection can achieve favorable local control in SGCT. When it is too difficult to complete en bloc resection, thoroughly piecemeal resection without residual is also acceptable, given the relatively low recurrence rate.
脊柱巨细胞瘤（SGCT）是一种相对罕见的原发性肿瘤。由于其侵袭性，整块切除术是首选的手术方法，但同时也会导致更多的并发症。我们报告了在一家中心超过 10 年的原发性胸腰椎脊柱巨细胞瘤整块切除术和分块切除术的围手术期并发症和局部控制的特点。
这是一项回顾性的横断面和队列研究。回顾性分析 2010 年至 2020 年在我院接受全肿瘤切除术并至少随访 24 个月的 41 例 SGCT 患者。收集并比较了不同手术方式的手术数据、并发症特点和局部肿瘤控制情况。
41 例患者纳入研究，男 18 例，女 23 例，平均年龄 34.2 岁。31 例病变位于胸椎，10 例病变位于腰椎。35 例为原发性病例，6 例为复发性病例。18 例行全节段椎体切除术（TES），12 例行 WBB 系统整块切除术，11 例行分块切除术。手术时间平均为 498 分钟，估计失血量平均为 2145 毫升。共记录了 58 例并发症，30 例（73.2%）至少发生了一次围手术期并发症。所有患者术后均随访至少 2 年。共有 6 例术后内固定失败，4 例局部肿瘤复发（9.8%）。
虽然手术技术难度大，围手术期并发症发生率高，但整块切除术可获得良好的局部控制。当整块切除困难时，彻底的无残留分块切除也是可以接受的，因为复发率相对较低。
